Name of Patient : Mrs.

DEEPA Test Request ID : 60792307300001

Age/Gender : 22 Yrs/Female Specimen Drawn ON : 30-Jul-2023 09:00AM
Collected AT : H S DIAGNOSTIC Specimen Received ON : 30-Jul-2023 02:58PM
Referred BY : Dr. R N H Report DATE : 30-Jul-2023 04:38PM
Sample Type : Serum - B115764
Ref Customer :

IMMUNOASSAY
Test Description Observed Value Biological Reference Range Method
THYROID PROFILE
Triiodothyronine Total (T3) 1.66 0.70-2.04 ng/mL Electrochemiluminescence
immunoassay (ECLIA)
Thyroxine Total (T4) 6.07 4.6-10.5 ug/dL Electrochemiluminescence
immunoassay (ECLIA)
TSH (4th Generation) 2.690 0.40-4.20 uIU/mL Electrochemiluminescence
immunoassay (ECLIA)

PREGNANCY REFERENCE RANGE for TSH IN uIU/mL (As per American Thyroid Association.)
1st Trimester 0.10-2.50 uIU/mL
2nd Trimester 0.20-3.00 uIU/mL
3rd Trimester 0.30-3.00 uIU/mL
INTERPRETATION-
1. Primary hyperthyroidism is accompanied by elevated serum T3 & T4 values along with depressed TSH level.
2 .Primary hypothyroidism is accompanied by depressed serum T3 and T4 values & elevated serum TSH levels.
3. Normal T4 levels accompanied by high T3 levels and low TSH are seen in patients with T3 thyrotoxicosis.
4. Normal or low T3 & high T4 levels indicate T4 thyrotoxicosis ( problem is conversion of T4 to T3)
5. Normal T3 & T4 along with low TSH indicate mild / subclinical HYPERTHYROIDISM .
6. Normal T3 & low T4 along with high TSH is seen in HYPOTHYROIDISM .
7. Normal T3 & T4 levels with high TSH indicate Mild / Subclinical HYPOTHYROIDISM .
8. Slightly elevated T3 levels may be found in pregnancy and in estrogen therapy while depressed levels may be encountered in severe illness , malnutrition ,
renal failure and during therapy with drugs like propanolol.
9. Although elevated TSH levels are nearly always indicative of primary hypothroidism . rarely they can result from TSH secreting pituitary tumours ( seconday
hyperthyroidism )
*TSH IS DONE BY ULTRASENSITIVE 4th GENERATION CHEMIFLEX ASSAY*
COMMENTS:
Assay results should be interpreted in context to the clinical condition and associated results of other investigations. Previous treatment with corticosteroid
therapy may result in lower TSH levels while thyroid hormone levels are normal. Results are invalidated if the client has undergone a radionuclide scan within 7-
14 days before the test. Abnormal thyroid test findings often found in critically ill clients should be repeated after the critical nature of the condition is
resolved.The production, circulation, and disintegration of thyroid hormones are altered throughout the stages of pregnancy.
Disclaimer-
TSH is an important marker for the diagnosis of thyroid dysfunction.Recent studies have shown that the TSH distribution progressively shifts to a higher concentration with age ,and it is debatable
whether this is due to a real change with age or an increasing proportion of unrecognized thyroid diseasein the elderly.
TSH levels are subject to circardian variation,reaching peak levels between 2-4AM and ninimum between 6-10 PM. The variation is the order of 50% hence
time of the day has influence on the measures serum TSH concentration.Dose and time of drug intake also influence the test result. r
Reference ranges are from Teitz fundamental of clinical chemistry 7th ed.

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Disclaimer:-This report is not for medico-legal purpose. For test performed on specimens received or collected from non-CRL locations, it is presumed that the specimen belongs to the patient named or identified as labeled on the container/test request and such verification has been
carried
out at the point generation of the said specimen by the sender. CRL will be responsible Only for the analytical part of test carried out. All other responsibility will be of referring Laboratory.sample processed and reported at CRL DIAGNOSTICS PVT. LTD , Delhi.
 Name of Patient : Mrs. DEEPA Test Request ID : 60792307300001
Age/Gender : 22 Yrs/Female Specimen Drawn ON : 30-Jul-2023 09:00AM
Collected AT : H S DIAGNOSTIC Specimen Received ON : 30-Jul-2023 02:58PM
Referred BY : Dr. R N H Report DATE : 30-Jul-2023 04:38PM
Sample Type : Serum - B115764
Ref Customer :

Test Description Observed Value Biological Reference Method

Range
Prolactin 21.91 <50 years : 3.34-26.72 Electrochemiluminescence
≥50 years: 2.74-19.64 ng/ml
Reference range in
Pregnancy,3rd trimester -95.00 - 473.00 ng/ml
Post Menopausal 1.80 –  20.30  ng/ml

Comments:
1.Since prolactin is secreted in a pulsatile manner and is also influenced by a variety of physiologic stimuli, it is recommended to test 3 specimens
at20-30 minute intervals after pooling.
2.Major circulating form of Prolactin is a nonglycosylated monomer, but several forms of Prolactin linked with immunoglobulin occur which can give
falsely high Prolactin results.
3.Macroprolactin assay is recommended if prolactin levels are elevated, but signs and symptoms of hyperprolactinemia are absent or pituitary
imaging studies are normal

Clinical Use
·Diagnosis & management of pituitary adenomas
·Differential diagnosis of male & female hypogonadism

Increased Levels
Physiologic: Sleep, stress, postprandially, pain, coitus
Systemic disorders: Chest wall or thoracic spinal cord lesions, Primary / Secondary hypothyroidism, Adrenal insufficiency, Chronic renal failure,
Cirrhosis
Medications: Psychiatric medications like Phenothiazine, Haloperidol,
Risperidone, Domperidone, Fluoexetine, Amitriptylene, MAO inhibitors etc.,
Antihypertensives: Alphamethyldopa, Reserpine, Verapamil,Opiates: Heroin, Methadone, Morphine, Apomorphine,Cimetidine / Ranitidine
Prolactin secreting pituitary tumors: Prolactinoma, Acromegaly
Miscellaneous: Epileptic seizures, Ectopic secretion of prolactin by non-pituitary tumors,pressure / transaction of pituitary stalk, macroprolactinemia
Idiopathic

Decreased levels
·Pituitary deficiency: Pituitary necrosis / infarction
·Bromocriptine administration
·Pseudohypoparathyroidism

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Disclaimer:-This report is not for medico-legal purpose. For test performed on specimens received or collected from non-CRL locations, it is presumed that the specimen belongs to the patient named or identified as labeled on the container/test request and such verification has been
carried
out at the point generation of the said specimen by the sender. CRL will be responsible Only for the analytical part of test carried out. All other responsibility will be of referring Laboratory.sample processed and reported at CRL DIAGNOSTICS PVT. LTD , Delhi.
 Name of Patient : Mrs. DEEPA Test Request ID : 60792307300001
Age/Gender : 22 Yrs/Female Specimen Drawn ON : 30-Jul-2023 09:00AM
Collected AT : H S DIAGNOSTIC Specimen Received ON : 30-Jul-2023 02:58PM
Referred BY : Dr. R N H Report DATE : 30-Jul-2023 04:38PM
Sample Type : Serum - B115764
Ref Customer :

Test Description Observed Value Biological Reference Method

Range
Follicle Stimulating Hormone (FSH) 5.54 mlU/mL Electrochemiluminescence
Comment :
Follicle Stimulating Hormone (FSH) regulates the development, growth, pubertal maturation, and reproductive processes of the
uman body. In both males and females, FSH stimulates the maturation of germ cells In males, FSH induces Sertoli cells to
secrete androgen binding proteins (ABPs) and its secretion is being regulated by inhibin's negative feedback mechanism on anterior pituitary gland. In females,
FSH initiates follicular growth, specifically affecting granulosa cells. With the concomitant rise in inhibin B, FSH levels then decline in the late follicular phase.
This seems to be critical in selecting only the most advanced follicle to proceed to ovulation. At the end of the luteal phase, there is a slight rise in FSH that seems
to be of importance to start the next ovulatory cycle.
Control of FSH release from the pituitary gland is unknown. Low frequency gonadotropin-releasing hormone (GnRH) pulses increase FSH mRNA levels in the rat,
however this doesn't directly correlate with an increase in circulating FSH. GnRH has been shown to play
an important role in the secretion of FSH, with hypothalamic-pituitary disconection leading to a cessation of FSH. GnRH administration leads to a return of FSH
secretion. FSH is subject to oestrogen feed-back from the gonads via the hypothalamic pituitary gonadal axis.

PREMENOPAUSAL
Mid-Follicular Phase: 3.85- 8.78 mlU/mL
Mid-Cycle Peak 4.54-22.51 mlU/mL
Mid-Luteal Phase 1.79-5.12 mlU/mL
POSTMENOPAUSAL
16.74- 113.59 mlU/mL

LH (leutinizing Hormone) 8.68 Premenopausal Chemiluminescence

Immunoassay(CLIA)
Mid-Follicular Phase: 2.12-
10.89
Mid-Cycle Peak : 19.18-
103.03
Mid-Luteal Phase: 1.20-12.86

Postmenopausal : 10.87-
58.64 mIU/mL
Comment
Luteinizing Hormone (LH) is a hormone produced by gonadotroph cells in the anterior pituitary gland. In females, an acute rise of LH ("LH surge")
triggers ovulation and development of the corpus luteum. LH supports theca cells in the ovaries that provide androgens and hormonal precursors for
estradiol production.

Nabl Scope.
*** End Of Report ***

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Disclaimer:-This report is not for medico-legal purpose. For test performed on specimens received or collected from non-CRL locations, it is presumed that the specimen belongs to the patient named or identified as labeled on the container/test request and such verification has been
carried
out at the point generation of the said specimen by the sender. CRL will be responsible Only for the analytical part of test carried out. All other responsibility will be of referring Laboratory.sample processed and reported at CRL DIAGNOSTICS PVT. LTD , Delhi.